Registration Form

PERSONAL INFORMATION

First Name (required)

Last Name (required)

Title

Date of Birth (required)

Your Email (required)

Phone (required)

Mailing Address (required)

City (required)

State (required)

Zip Code (required)

Church Membership

Present Ministry Position

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COLLEGE/SEMINARY DEGREES EARNED TO DATE:

Degree

Year

School

Miscellaneous Info

Degree

Year

School

Miscellaneous Info

Degree

Year

School

Miscellaneous Info

Degree

Year

School

Miscellaneous Info

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DEGREE SOUGHT AT PSCS:

Pastoral Ministry Degrees:

 Associate of Ministry (60 undergrad. credit hours) Bachelor of Ministry (120 undergrad. credit hours) Master of Ministry (30 grad. credit hours) Master of Theology (60 grad. credit hours) Master of Divinity (90 grad. credit hours) Doctor of Ministry (120 grad. credit hours) Doctor of Theology (150 grad. credit hours)

(Undergraduate and Graduate credit hours are cumulative)

Christian Counseling Degrees:

 Associate of Ministry (60 undergrad. credit hours) Bachelor of Ministry (120 undergrad. credit hours) Master of Christian Counseling (45 grad. credit hours) Master of Christian Psychology (75 grad. credit hours) Doctor of Christian Counseling (60 grad. credit hours) Doctor of Christian Psychology (45 grad. credit hours)

(Undergraduate and Graduate credit hours are cumulative)

Master's and Doctoral Degrees in Christian Counseling, please select study method:

 Online Text & Exams Hard Copy Text & Exams Not Sure

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NOTE: Registration cannot be processed without payment of the $50 registration fee. All fees are payable in U.S. dollars only.

Payment Method:

 Check/Money Order Credit Card/PayPal (see below)

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Online Signature:

 Check box, if you accept terms below.

Today's Date

* Note: This form can be submitted via the internet by filling it out completely and clicking on the submit button above. Or it may be filled out using your computer’s keyboard, then printed . . . or you may print it out and enter the information by hand.

Fill out and mail this form, along with a non-refundable $50 registration fee (payable in U.S Dollars only). NOTE: Please request 3 letters of reference from persons who know you well: at least one letter from an employer or someone familiar with your career, and another letter from someone familiar with your academic performance. Other optional items you may send include a current resume and a recent photograph.

Then read and sign the following statement:

“The information supplied on my application is true and accurate. I give permission for officials of Pillsbury College & Seminary to verify and confirm any aspect of the information provided on this form and on supporting documents. I understand and accept that if at any time it is determined that I have misrepresented myself or my work, I may be dismissed from Pillsbury-Scarborough Bible College & Seminary with no refund of fees paid, and that any degree(s) awarded may be rescinded.”